Individual provider Active NPI

Robin C Wiley, MSW, LCSW

  • Clinical Social Worker
  • Haddon Township, NJ
National Provider Identifier
1235272840
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05263500 Issued in NJ
Practice address
215 Highland Ave
Suite C
Haddon Township, NJ 08108-2634
Phone
(856) 854-3155
Fax
(609) 747-9968
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05263500 NJ Primary

Addresses

Primary practice location

215 Highland Ave
Suite C
Haddon Township, NJ 08108-2634

Mailing address

PO Box 636
Burlington, NJ 08016-0636
Phone (609) 747-9391

Other identifiers 1

IdentifierTypeStateIssuer
0065161MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115000298 NJ Practitioner - Clinical Social Worker 2062715642 Reassigns benefits to 2 organizations
Practice locations: Cherry Hill, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Executive Campus
308 Infinity Empowerment Services
Cherry Hill, NJ 08002-4102
Phone (609) 346-2409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC Clinical CurrentSince Jan 1, 2016 Accepting new patients
Clare Medical of New Jersey LLC Clinical CurrentSince Apr 1, 2016 Accepting new patients
Infinity Empowerment Services Clinical PastSince Nov 28, 2018 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

137 High St
Ste 2A
Mount Holly, NJ 08060
Phone (609) 447-3442

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11700/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1235272840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080160636",
            "telephone_number": "609-747-9391",
            "fax_number": "609-747-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HIGHLAND AVE",
            "address_2": "SUITE C",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082634",
            "telephone_number": "856-854-3155",
            "fax_number": "609-747-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "ROBIN",
        "middle_name": "C",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05263500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065161",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haddon Township, NJ

Sources for this page

Verify at the official NPI Registry.